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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - REVENUE RECOVERY GROUP INCOctober 12, 2018 Revenue Recovery Group Inc Attn: King Woolf 11924 Coursey Blvd, Ste C Baton Rouge, LA 70816 RE: Contract Renewal, Work Order Services Agreement with Revenue Recovery Group Inc Dear Mr. Woolf: The City of Fort Collins wishes to extend the agreement term for the above captioned proposal per the existing terms and conditions and the following: 1) The term will be extended for one (1) additional year, January 1, 2019 through December 31, 2019. If the renewal is acceptable to your firm, please sign this letter in the space provided and include a current copy of your insurance certificate naming the City as an additional insured for General and Automotive Liability within the next fifteen (15) days. If this extension is not agreeable with your firm, we ask that you send us a written notice stating that you do not wish to renew the contract and state the reason for non-renewal. Please contact me at (970) 221-6779 if you have any questions regarding this matter. Sincerely, Gerry S. Paul Director of Purchasing __________________________________________ ________________ Signature Date (Please indicate your desire to renew the Services Agreement by signing this letter and returning it to Purchasing Division within the next fifteen days.) GSP:kr Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707- fax fcgov.com/purchasing DocuSign Envelope ID: 8551F91B-B60F-4477-8A5D-B66281AFB35B 10/15/2018 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: REVEREC-02 1 1 Arthur J. Gallagher Risk Management Services, Inc. Revenue Recovery Group, Inc.; Discovery Audit Serv 12012 Bricksom Avenue Baton Rouge, LA 70816 25 CERTIFICATE OF LIABILITY INSURANCE General Liability Endorsement: Additional Insured (Owners, Contractors or Lessors) - Blanket When Required by Written Contract - BP04020106 Commercial Umbrella Endorsement: Waiver Transfer Rights of Recovery Against Others - CU64951207 Cyber Liability - 6/6/2018 - 6/6/2019: Policy Limit of Liability - $10,000,000 Each Claim or Event Rentention - $10,000 Aggregate DocuSign Envelope ID: 8551F91B-B60F-4477-8A5D-B66281AFB35B SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ PROPERTY DAMAGE $ BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOS ONLY AUTOS NON-OWNED OWNED SCHEDULED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: REVEREC-02 1 1 Arthur J. Gallagher Risk Management Services, Inc. Revenue Recovery Group, Inc.; Discovery Audit Serv 12012 Bricksom Avenue Baton Rouge, LA 70816 25 CERTIFICATE OF LIABILITY INSURANCE General Liability Endorsement: Additional Insured (Owners, Contractors or Lessors) - Blanket When Required by Written Contract - BP04020106 Commercial Umbrella Endorsement: Waiver Transfer Rights of Recovery Against Others - CU64951207 Cyber Liability - 6/6/2018 - 6/6/2019: Policy Limit of Liability - $10,000,000 Each Claim or Event Rentention - $10,000 Aggregate (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 10/16/2018 Arthur J. Gallagher Risk Management Services, Inc. 235 Highlandia Drive, Suite 200 Baton Rouge LA 70810 Renee Meaux 225-906-1271 225-292-3893 renee_meaux@ajg.com American Fire and Casualty Company 24066 REVEREC-02 Ohio Casualty Insurance Company 24074 Revenue Recovery Group, Inc.; Discovery Audit Serv 12012 Bricksom Avenue Baton Rouge, LA 70816 Travelers Casualty and Surety Company 19038 Illinois Union Insurance Company 27960 423155062 A X 2,000,000 X 50,000 5,000 4,000,000 X Y N BZA57693820 6/16/2018 6/16/2019 4,000,000 A 1,000,000 X X BZA57693820 6/16/2018 6/16/2019 B X X 1,000,000 N Y USO57693820 6/16/2018 6/16/2019 1,000,000 X 10,000 C N UB0L0607511842G 6/16/2018 6/16/2019 X 1,000,000 1,000,000 1,000,000 A D Employee Benefits Liability Professional Liability N N BZA57693820 EONLAF112758374 6/16/2018 6/16/2018 6/16/2019 6/16/2019 Aggregate Limit Aggregate Limit $2,000,000 $3,000,000 Complete Named Insured for the Liability Policy: Revenue Recovery Group, Inc. and King Woolf Discovery Audit Services, LLC Complete Named Insured for the Workers Compensation Policy: Revenue Recovery Group, Inc. Discovery Audit Services, LLC See Attached... City of Fort Collins PO Box 580 Fort Collins CO 80522 USA (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER (MM/DD/YYYY) LIMITS POLICY EXP (MM/DD/YYYY) POLICY EFF LTR TYPE OF INSURANCE POLICY NUMBER INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB EACH OCCURRENCE $ AGGREGATE $ $ OCCUR CLAIMS-MADE DED RETENTION $ PRODUCTS - COMP/OP AGG $ GENERAL AGGREGATE $ PERSONAL & ADV INJURY $ MED EXP (Any one person) $ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 10/15/2018 Arthur J. Gallagher Risk Management Services, Inc. 235 Highlandia Drive, Suite 200 Baton Rouge LA 70810 Renee Meaux 225-906-1271 225-292-3893 renee_meaux@ajg.com American Fire and Casualty Company 24066 REVEREC-02 Ohio Casualty Insurance Company 24074 Revenue Recovery Group, Inc.; Discovery Audit Serv 12012 Bricksom Avenue Baton Rouge, LA 70816 Travelers Casualty and Surety Company 19038 Illinois Union Insurance Company 27960 1613290032 A X 2,000,000 X 50,000 5,000 4,000,000 X N BZA57693820 6/16/2018 6/16/2019 4,000,000 A 1,000,000 X X BZA57693820 6/16/2018 6/16/2019 B X X 1,000,000 N USO57693820 6/16/2018 6/16/2019 1,000,000 X 10,000 C N UB0L0607511842G 6/16/2018 6/16/2019 X 1,000,000 1,000,000 1,000,000 A D Employee Benefits Liability Professional Liability N N BZA57693820 EONLAF112758374 6/16/2018 6/16/2018 6/16/2019 6/16/2019 Aggregate Limit Aggregate Limit $2,000,000 $3,000,000 Complete Named Insured for the Liability Policy: Revenue Recovery Group, Inc. and King Woolf Discovery Audit Services, LLC Complete Named Insured for the Workers Compensation Policy: Revenue Recovery Group, Inc. Discovery Audit Services, LLC See Attached... City of Fort Collins PO Box 580 Fort Collins CO 80522 USA DocuSign Envelope ID: 8551F91B-B60F-4477-8A5D-B66281AFB35B